Current State of Veteran’s Healthcare:
“Wonder why 22 veterans kill themselves every day?” was a comment made by Chris Dorsey, an Iraq War veteran, as he was turned away from receiving care at an Atlanta VA clinic (Mallin 2015). Chris Dorsey’s remark echoes the feeling of anger shared by millions of veterans who have faced the constant uphill battle to gain consistent, accessible, and beneficial healthcare. Understanding the inequities and barriers to healthcare for veterans is instrumental in shaping a new future of veterans’ healthcare that departs from the largely poor standard of care currently received by Chris Dorsey and millions of veterans.
Among the over 22 million veterans currently living in the United States, research shows that roughly 33% were diagnosed with at least one mental health disorder. One in ten has a substance use disorder (Olenick 2015, Teeters et al. 2017, Schaeffer 2021). For veterans who served during Iraq or Afghanistan, between 14-16% reported having PTSD or depression (Inoue et al., 2021). Compared to the general population, veterans experience PTSD at four times the rate and are 1.5 times more likely to commit suicide (Johnson et al., 2013, Reisman, 2016). While many suffer from mental health disorders, veterans are also collectively more likely to be unemployed and homeless than nonveterans.
Congress has allocated over one billion dollars for suicide prevention for veterans in 2021 alone (Green, 2021). Moreover, they passed the Veterans Mental Health Care Improvement Act to improve veterans’ access to mental health resources (Scott, 2019). Despite these efforts, current solutions have not fully addressed the systemic factors that have hindered the quality of healthcare received by veterans. Some of these factors include the underdevelopment of infrastructure within rural communities, barriers to VA benefits, and male mental health stigmatization.
Over 4.7 million veterans live within rural communities, which have been underinvested, thus leaving behind increased barriers to obtaining consistent, quality healthcare (Rural Health Information Hub). Record numbers of hospital closures, 0.5% of US foundation grants targeted at rural communities for medical research, and 26.4% of rural residents lacking broadband are only a few examples of the historic underinvestment in rural communities (Dorfman, 2016; Pender 2015). The VA has attempted to increase access for rural veterans through the growth of community-based outpatient clinics (CBOC) in tandem with telemedicine; however, the fundamental problems within rural communities are still prevalent (Borowsky et. al, 2002). Terry Ray Beasley, a seventy-year-old veteran currently living in Eureka, Montana, has witnessed the increased presence of telemedicine within his community. While noting the benefits of the newfound telemedicine pod in Eureka, Mr. Beasley mentions that many veterans’ trust in receiving adequate treatment has gradually decayed (Markert, 2020). Outside of a lack of trust, many rural communities face elevated rates of poverty, healthcare worker shortages, and hospital closures (Richman et. al, 2019; Warshaw, 2017).
Therefore, the extent of the benefits provided by the emergence of CBOC’s and telemedicine will continue to be inhibited without a substantial investment into the growth of rural communities and re-establishing the trust of veterans in receiving quality healthcare. Given that the average age of veterans continues to increase, this further perpetuates the urgency of needing to invest in the healthcare and overall infrastructure of rural communities.
Tribulations in VA Benefits:
In tandem with physical barriers inhibiting veterans from receiving consistent healthcare access, the VA has also historically increased the difficulty of obtaining benefits that veterans are entitled to, which in the process has isolated veterans. Several examples include the Blue Water Navy Veterans who were impacted by the harmful effects of chemical warfare, who just now are eligible for benefits, and Afghanistan and Iraq War veterans who suffered from the detrimental impacts of open burn pits (Kassraie, 2021;Yang, 2021). Jason Howard, a forty-four-year-old Iraq veteran, has struggled to obtain the necessary benefits and is going through the appeal process as he suffers from glaucoma (Yang, 2021). In addition to those who have had to fight to receive benefits while suffering from severe medical conditions, they also face the uphill journey of obtaining help due to their discharge status. Veterans who finish their military career with a “less than honorable” discharge remain ineligible for many veteran benefits. Currently, the VA estimates that there are over 500,000 less than honorable discharged veterans, which has complicated their ability to receive benefits (Walsh, 2018). Many veterans who received less than honorable discharges stem from the “Don’t Ask, Don’t Tell” policy that was prevalent until its repeal in 2011.
Before enacting “Don’t Ask, Don’t Tell,” LGBTQ members were banned from joining the military. If military members were found to be under the “homosexual category,” then they were discharged from the military (Pruitt, 2019). The “Don’t Ask, Don’t Tell” lifted the ban on members of the LGBTQ community from serving in the military; however, over 13,000 military members were still discharged due to their presumed or known sexuality (Beals, 2020). A total of over 100,000 military members over seventy years are suspected of having been discharged due to their sexuality (Zaru 2021). While there have been movements on behalf of the VA to ensure full VA benefits to LGBTQ military members and veterans, Jennifer Dane, a former Air Force veteran impacted by the “Don’t Ask, Don’t Tell,” shows we still have a long way to go. Dane stated, “some LGBTQ veterans who were discharged under “don’t ask, don’t tell” still do not get access to medical care, the GI Bill and military pension” (Beals, 2020). For those impacted by the “Don’t Ask, Don’t Tell” and other veterans who received less than honorable discharges, they can repeal their current status and overturn their discharge status. However, even if one can overturn their discharge status, they join incredibly long and tenuous waitlist lines for VA claims.
The pandemic has further exacerbated the backlog of veterans claims to over 215,000, which is three times higher than in 2020 . Still, before 2015, the backlog was over 600,000 (Leo III, 2021). On top of the backlog for disability and benefits claims, veterans are subjected to incredibly long wait times throughout most VA centers. Curtis Shanley, a former Marine, in an interview with Vice, described the agony of suffering through these long wait lines.
“It took six months to get an MRI, another three months for a specialist that sees the MRI, another three months to see another three months to see a primary care physician to schedule with a specialist…I got out five years, and I am still waiting…good luck to the guy getting out now.” (Glazer, 2014)
Veterans should not have to wait long times, proving why they deserve care and slowly dying in long wait lines. We need a reimagined system that can effectively reduce the backlog while comprehensively investigating each case and promptly providing the necessary solution. The recent hire of over 2,000 VA personnel is a start, but continued investment into reducing the backlog over the coming decades is of critical importance (VA, 2021)
Veteran Mental Health Stigmatization:
Male mental health stigmatization provides another layer on top of the existing barriers for veterans discussed thus far. In an interview with CNN, Seth Robbins, an Army veteran, described the feeling that has happened with most military members when they leave the service “As soldiers, sailors, Marines, and airmen, we are taught to ‘suck it up and drive on.’ We heard that on a regular basis, and it gets into your head.” Many veterans carry this weight on them every day after they leave the service; however, they restrain themselves from getting help (Christensen 2018). Fidel Gomez-Torres, a Navy Veteran, describes being told after deployment to get help but did not seek help.
“I felt fearful of going and getting diagnosed. I feel like there was such a stigma and still is around having PTSD. There is this idea of brokenness that you carry. And for me, I’ve always been high functioning. I’ve always been an overachiever. And the idea that something had changed fundamentally and that I could no longer be the person that I’ve always known myself and took pride in being made me very afraid.” (Hobson 2019)
Therefore, mental health resources need to be increasingly made available for veterans; however, many veterans remain inhibited by the societal stereotypes of being diagnosed with any mental health disorders and seeking help. A study from the University of West Virginia found that those who have PTSD most often held stereotypes of “dangerousness and incompetence,” leading to social exclusion (Hipes 2018). A separate study by the VA Health Services Research and Development found these same stereotypes, and many avoided treatment to avoid these labels (Mittal et. al, 2013). Still, the treatment did eventually help veterans resist associating themselves with these stereotypes. Conversations about mental health have become more prevalent. However, we still have more work to do to deconstruct the stereotypes related to seeking mental health treatment, especially for men. We need to continue to be there for the military community throughout their deployments, and as soon as they get home, continue to advocate for veterans to get the mental help they may need.
“VA should function as an advocate of care for the veteran, not as an obstacle of care” was a quote from Jon Stewart, famed host of the Daily Show who has turned into an advocate for 9/11 responders and veterans (Yang 2021). The VA has made strides in the right direction by opening up CBOC’s, increasing mental health resources, and correcting errors of the past which should be appreciated and noted. However, we have a long way to go in providing care and resources for all veterans and rebuilding trust within veterans that they can receive adequate healthcare. Stories gathered by Concerned Veterans for America unveil an abundance of stories of veterans who hold onto distrust for the VA. Rocky, a Navy Veteran, feels “abandoned in general,” and Clay, an Army Veteran, said, “Twenty years of botched care, delayed care, denied care…undiagnosed and untreated physical condition has led to an absolute annihilation of my mental state” (Concerned Veterans for America). Our veterans deserve better, and they deserve to have the highest quality of care given the highest levels of sacrifices that they have made for our freedoms. We need to hold the VA accountable for their promises to continue to provide the highest level of care for Veterans.
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